Alerts & Bewares

Children's cough and cold medicines raise concerns among physicians.

In continuing coverage from yesterday's briefing, the Wall Street Journal (10/2, B11, Mathews, Bernstein) reports, "Drugstore shelves are full of cough and cold medications marketed for babies and toddlers, but doctors are increasingly opposed to the medicines' use." Last week's safety reviews by the FDA "have added to the debate, leaving parents with a dilemma: How should they treat very young children suffering from runny noses and other mild but unpleasant symptoms?"

The Journal notes, "Pediatricians suggest falling back on a range of old-fashioned therapies that may help, and will often provide comfort to a sick kid.

These include

humidifiers,

saline drops and, yes,

hydrating fluids such as the classic chicken soup."

However, they suggest that parents consult a physician if the symptoms persist for several days. Currently, the FDA is still deciding how to handle these drugs.

In the meantime, parents are advised "'to be extremely cautious about using the products, and [to] be very aware of the ingredients,' so they don't inadvertently give young children two formulations that contain the same active drug."

Antibiotic, minocyline, may reduce stroke damage, study suggests.

HealthDay (10/2, Perkel) reports, "An antibiotic [minocyline] used to treat severe acne and urinary tract infections also appears to be a potent weapon against acute ischemic stroke," according to a study published in today's issue of Neurology. Dr. Yair Lampl, of Tel Aviv University, and colleagues, "randomized 152 patients with acute ischemic stroke into two groups, one of which received 200 milligrams of minocycline a day for five days, while the other was given a placebo.

Treatment was initiated between six and 24 hours after stroke onset." They found that after "one week, one month and three months following stroke, patient recovery was significantly improved in the antibiotic group relative to the control group on each of three tests that collectively assess neurological damage due to stroke and the patient's ability to perform daily tasks such as grooming, dressing and going to the bathroom."

Male, female physicians make heart diagnoses in significantly different ways, study suggests.

The New York Times (10/2, F7, Bakalar) reports that there are "significant differences in the ways male and female doctors" diagnose coronary heart disease, according to research published online Aug. 30 in Sociology of Health and Illness. The study suggests that "male doctors might be less biased by the gender and age of the patient being examined." Researchers "videotaped professional actors portraying patients of varying gender, age, race and socioeconomic status who all had medically apparent symptoms of heart disease."

After 112 primary care doctors viewed the tapes, they were "asked to...make a diagnosis and suggest a treatment plan," as well as "describe what factors they considered in arriving at their decisions."

Even though "both male and female doctors picked up more psychological cues from female patients," female doctors made more observations "about a patient's self-presentation," and they most often made these observations regarding female patients. Furthermore, while an "older age is a significant risk factor for heart disease in both men and women, female doctors paid significantly less attention to female patients' ages than those of males."

Children can have heart attacks, physicians indicate.

HealthDay (10/2) reports, "Heart attacks in children are a rare but under-recognized health issue, say Ohio doctors who documented nine cases of heart attacks in children as young as 12 that occurred between 1995 and 2006," according to findings in the October issue of Pediatrics. None of the children, eight boys and one girl, "had [any] common heart attack risk factors such as obesity, high blood pressure, drug abuse, unhealthy cholesterol levels, or family history." The AP (10/1, Tanner) added that according to Dr. John Lane, of Akron Children's Hospital in Akron, Ohio, "The cause of their heart attacks was most likely a heart spasm that briefly cut off blood supply."

This is a rare cause of adult heart attacks. Dr. Reginald Washington, a Denver children's heart specialist, noted, "Chest pain is a common symptom in children, but 95 percent of the time, it's not heart-related and it is rarely life-threatening." As a rule, Dr. Lane advised parents to "consult a doctor any time a child has sudden chest pain. A heart attack in children is typically a crushing-type pain that radiates to the arm or jaw or neck -- similar to adults' symptoms."

Maternal weight gain may predict baby's gender, study indicates.

The UPI (9/26) reports, "Moms who gain weight from the beginning of a first pregnancy to the beginning of a second may be more likely to have a boy,' according to a study published in the journal Fertility & Sterility. MedPage Today (9/26, Bankhead) adds that Eduardo Villamor, M.D., of Harvard University, and colleagues, "examined potential influences on sex ratio in data from the Swedish Birth Registry." They analyzed data from "220,889 women who had two consecutive singleton births between 1992 and 2004. Live births and stillbirths were included in the analysis." MedPage Today continues, "The birth registry data [also] included the women's weight and height at the first antenatal visit of both pregnancies. Smoking status was ascertained from data in birth and education registries." Dr. Villamor's research team found that among "women whose body mass index increased by more than 3 kg/m2 between a first and second pregnancy, the odds ratio of male conception increased from 1.024 to 1.080."


Study suggests omega-3 fatty acids may lower risk of Type 1 diabetes in children.

MedPage Today (9/26, Groch) reports, "A higher intake of omega-3 fatty acids found in fish was linked to a lower risk of pancreatic islet autoimmunity in children at genetic risk for type 1 diabetes," according to a preliminary study published in today's issue of the Journal of the American Medical Association. Jill M. Norris, M.P.H, Ph.D., of the University of Colorado, and colleagues, "undertook a longitudinal, observational study, the Diabetes Autoimmunity Study in the Young (DAISY)," in order to "examine the role of omega-3 and omega-6 fatty acids in the etiology of diabetes." They found that "omega-3 fatty acid intake was associated with a 55 percent reduced risk of islet autoimmunity." Furthermore, "The association reached a 77 percent decreased risk when the definition of the outcome was limited to those positive for two or more autoantibodies." MedPage Today continues, "The study was conducted in Denver, from January 1994 through November 2006 and included 1,770 children at increased risk for type 1 diabetes, defined as either possession of HLA genotype for a high diabetes risk or having a sibling or parent with type 1 diabetes."

Chronically angry men more likely to develop hypertension, heart disease

WebMd (9/26, Hitti) reports that "having a short fuse may shorten the path to heart disease in men with prehypertension," according to research reported in the current edition of the Annals of Family Medicine. Researchers at the Medical University of South Carolina followed "2,334 U.S. adults aged 48-67" for "four to eight years during the 1990s." The researchers found that, "[c]ompared with less angry men, chronically angry men with prehypertension were moderately more likely to develop high blood pressure...and heart disease during the study." While the "same wasn't true for women" in the study, the researchers said that, "[f]or men and women alike, long-term psychological stress was linked to heart disease."

Welch Allyn defibrillators Recalled

HealthDay (9/20) reports, "A Class I recall for MRL/Welch Allyn AED 20 Automatic External Defibrillators has been issued by the" FDA.

"A Class I recall, the most serious type, involves situations where there's a reasonable probability that the use of a product will cause serious injury or death."

Typically, emergency or medical personnel use AEDs to treat patients experiencing heart attacks. The recall includes defibrillators manufactured "between October 2003 and January 2005, with serial numbers 205787 through 207509."

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